Changes for all Scheme participants
Provisional liability
The new legislation includes the introduction of provisional liability - a process in which WorkCover begins paying income and medical costs for a new claim within 7 days rather than waiting for the claim to be determined.
Provisional weekly compensation payments will start within seven days for up to 13 weeks. If the claim is ultimately rejected, WorkCover will absorb the costs, except in cases of fraud. Experience in NSW shows that absorbing the cost of claims that are ultimately rejected in this initial period is far more cost effective than delayed rehabilitation and return to work.
From 1 July 2009, some changes have been made to provisional liability click here for more information.
Download factsheet: Provisional liability
Download guidelines: Provisional payment guidelines
View provisional liability FAQs
Dispute resolution structure
The structure of the dispute resolution system is important for ensuring that the right decisions are made in a timely manner, that they are fair with avenues for appeal and that unnecessary delays are avoided. It is also important that the dispute process does not itself become a barrier to return to work.
The new structure for dispute resolution is as follows:
New structure
- Conciliation
- Judicial determination (Single Presidential Member)
- Full Bench of the Workers Compensation Tribunal
- Appeal to Full Supreme Court on special leave
From 1 January 2009 this change applies to existing and new disputes made on or after 1 January 2009.
Download factsheet: Disputes
Legal costs
The new arrangements for legal costs were due to start on 1 January 2009. However, further consideration and consultation is required before these changes come into effect.
WorkCover will keep stakeholders informed of progress on these changes in due course.
Decision making on medical issues
All workers compensation disputes are determined by the Workers Compensation Tribunal, unless resolved by consent by the parties involved. It is estimated that between 45% and 50% of disputes occur because of disagreement over a medical matter.
The review found that the South Australian dispute resolution system was less effective than other jurisdictions and suffered from ’dueling doctors‘ – when opposite parties present opposing medical opinions about a worker’s injury, illness or capacity for work.
Under the previous system, it became the judges who determined the medical questions rather than the medical experts. Therefore, the review proposed the establishment of an independent medical panel so that decisions on medical questions would be made by suitably experienced medical experts. The medical panel model for South Australia draws on the best aspects of the Victorian and Queensland models.
The Government will consult with stakeholders on appointments to the medical panels before panel members are appointed by the Governor and the new system becomes effective from 1 April 2009.
Innovations with a return to work fund
Under the reform package, a $15 million return to work fund will be established to improve rehabilitation and retraining activities, and to fund projects and research to improve return to work outcomes. A stakeholder reference group will have input into the setting of annual priorities for the return to work fund. There is a significant number of workers who, as a result of injury or illness are unable to return to their pre-injury employment but who, nevertheless, have valuable skills and experience. The return to work fund will support initiatives that will assist these workers to return to work, in particular, in areas where there are current skills shortages.
The return to work fund was established on 1 July 2008.
WorkCover Ombudsman
An office of the WorkCover Ombudsman has been established as an independent office to investigate complaints relating to the operation of the WorkCover Scheme. It will report to the Minister for Industrial Relations. The Ombudsman has responsibility to report on wider issues that may exist behind individual complaints. The Ombudsman implements the 'safety net' for injured workers testing the reasonableness of decisions to stop weekly payments.
Find out more about the Ombudsman.
The Ombudsman function became effective from 1 July 2008.
Return to work inspectorate
A return to work inspectorate is being established to oversee WorkCover’s and employers’ responsibilities in relation to return to work. It will provide advice and enforce employer’s obligations to return injured workers to work. The inspectorate is based on the Victorian approach.
This change became effective from 1 July 2008.
Auditor-General
The WorkCover Corporation Act 1994 has also been amended to require WorkCover to be audited by the Auditor-General. This will give employers, employees and the community the same level of transparency and confidence in the operations of WorkCover that other Government business enterprises, audited by the Auditor-General, provide to stakeholders.
The Auditor-General’s responsibilities for WorkCover commenced on 1 July 2008.
Engage with workforce development strategies
Following a workers compensation claim, there is an obligation upon employers to return a worker to alternative suitable employment within the employer’s organisation. Sometimes such alternatives are not possible and, in these situations, return to work with a different employer has to be considered. WorkCover is now engaging with existing workforce development strategies and initiatives, such as South Australia Works, Industry Skill Boards and Group Training Organisations, to enhance the employment opportunities for injured and ill workers.
WorkCover will also look into programs which have been successful at returning people to work who have been out of the workforce for long periods of time. For example, programs such as Goal 100 in Whyalla may provide valuable lessons in fashioning an approach or approaches for dealing with the long-term group of WorkCover claimants who are experiencing barriers to return to work.
These initiatives became effective from 1 July 2008.